Services for people with chronic obstructive pulmonary disease
This is an extract from the commissioning guide. The complete commissioning guide is available at www.nice.org.uk/guidance/cmg43
6 The commissioning and benchmarking tool
- 6.1 Identify indicative local service requirements
- 6.2 Review current commissioned activity
- 6.3 Identify future change in capacity required
- 6.4 Model future commissioning intentions and associated costs
- 6.5 Potential savings
Use the commissioning and benchmarking tool for 'Services for people with COPD' to determine the level of service that might be needed locally and to calculate the cost of commissioning the service, as described below.
There are four indicative benchmark rates used in the tool:
For establishing a new pulmonary rehabilitation service, the indicative benchmark is 0.41% or 410 per 100,000 population aged 18 years or older per year.
For an existing pulmonary rehabilitation service, the indicative benchmark is 0.026% or 26 per 100,000 population aged 18 years or older per year.
For establishing eligibility for an assisted discharge scheme, the indicative benchmark is 0.086% or 86 per 100,000 population aged 18 years or older per year.
For the annual number of deaths attributable to COPD, the indicative benchmark is 0.054% or 54 per 100,000 population aged 18 years or older per year.
The commissioning and benchmarking tool helps you to assess local service needs using the indicative benchmarks as a starting point. With knowledge of your local population and its demographic, you can amend the benchmarks to better reflect your local circumstances. For example, if your population is significantly younger or older than the average population, or has a significantly higher or lower rate of COPD, you may need to provide services for relatively fewer or more people.
The supportive and palliative care worksheet contains a benchmark that can be used as an indicator of the level of activity that may be required to be commissioned for palliative and end-of-life care for people with COPD. Because the need for palliative and end-of-life care services is subject to local variation, it is not possible to cost out a service model. However, commissioners and providers may wish to refer to the guide text that details commissioning considerations for supportive and palliative care for people with COPD.
You may already commission services for people with COPD for your population. The tool provides tables that you can populate to help you calculate your current commissioned activity and costs.
Using the indicative benchmarks provided, or your own local benchmarks, you can use the commissioning and benchmarking tool to compare the activity that you might need to commission against your current commissioned activity. This will help you to identify the future change in capacity needed. Depending on your assessment, your future provision may need to be increased or decreased.
You can use the commissioning and benchmarking tool to calculate the capacity and resources needed to move towards the benchmark levels for pulmonary rehabilitation and assisted discharge, and to model the necessary changes over a period of 4 years.
Use the tool to calculate the level and cost of activity you intend to commission for pulmonary rehabilitation and assisted discharge. The tool is pre-populated with data on the staff resource needed and potential recurrent and non-recurrent cost elements that may need to be considered in future service planning, which can be reviewed and amended to better reflect your local circumstances.
Commissioning decisions should consider both the clinical and economic viability of the service, and take into account the views of local people. Commissioning plans should also take into account the costs of monitoring the quality of the services commissioned.